Linda Chan1, Shelley J E Hwang2, Karen Byth3, Merribel Kyaw4, Matteo S Carlino5, Shaun Chou6, Pablo Fernandez-Penas2. 1. Department of Dermatology, Westmead Hospital, Sydney, Australia. Electronic address: lindachan.health@gmail.com. 2. Department of Dermatology, Westmead Hospital, Sydney, Australia; Sydney Medical School, The University of Sydney, Westmead, Australia. 3. Research and Education Network, Western Sydney Local Health District, Westmead Hospital, Westmead, Australia; NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Sydney, Australia. 4. Department of Radiology, Westmead Hospital, Sydney, Australia. 5. Crown Princess Mary Cancer Centre, Westmead and Blacktown Hospitals, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, Sydney, Australia. 6. Tissue Pathology and Diagnostic Oncology, Westmead Hospital, Sydney, Australia.
Abstract
BACKGROUND: The treatment response to new immunotherapy in advanced melanoma patients remains varied between individuals. Immune-related cutaneous side effects might have prognostic value. OBJECTIVE: To determine whether development of ≥1 of the 3 immune-mediated cutaneous events (eczema, lichenoid reaction, or vitiligo-like depigmentation) is associated with improved progression-free survival. METHODS: A cohort study of adults with stage IIIC-IV melanoma treated with pembrolizumab or nivolumab during May 1, 2012-February 1, 2018, at Westmead Hospital, Sydney, Australia. Treatment response was based on iRECIST version 1.1. RESULTS: In total, 82 patients of an average age of 59.9 years were included. Median follow-up was 40.7 months; 33 patients had ≥1 target skin reaction. Skin reactions developed in one-third of individuals by 6 months. At any given time, the instantaneous risk of disease progression and death was lower for individuals who had ≥1 cutaneous adverse event (CAE) develop. Compared with individuals with no CAE, the hazard ratio for disease progression and death for individuals who had ≥1 CAE develop was 0.46 (95% confidence interval 0.23-0.91; P = .025) by the time-dependent Cox proportional hazards model. LIMITATIONS: Single-center study. CONCLUSION: This study demonstrates an association between the development of ≥1 of 3 CAEs and improved progression-free survival in this cohort of patients.
BACKGROUND: The treatment response to new immunotherapy in advanced melanomapatients remains varied between individuals. Immune-related cutaneous side effects might have prognostic value. OBJECTIVE: To determine whether development of ≥1 of the 3 immune-mediated cutaneous events (eczema, lichenoid reaction, or vitiligo-like depigmentation) is associated with improved progression-free survival. METHODS: A cohort study of adults with stage IIIC-IV melanoma treated with pembrolizumab or nivolumab during May 1, 2012-February 1, 2018, at Westmead Hospital, Sydney, Australia. Treatment response was based on iRECIST version 1.1. RESULTS: In total, 82 patients of an average age of 59.9 years were included. Median follow-up was 40.7 months; 33 patients had ≥1 target skin reaction. Skin reactions developed in one-third of individuals by 6 months. At any given time, the instantaneous risk of disease progression and death was lower for individuals who had ≥1 cutaneous adverse event (CAE) develop. Compared with individuals with no CAE, the hazard ratio for disease progression and death for individuals who had ≥1 CAE develop was 0.46 (95% confidence interval 0.23-0.91; P = .025) by the time-dependent Cox proportional hazards model. LIMITATIONS: Single-center study. CONCLUSION: This study demonstrates an association between the development of ≥1 of 3 CAEs and improved progression-free survival in this cohort of patients.
Authors: Alexandre Gérard; Jerome Doyen; Henri Montaudié; Barbara Seitz-Polski; Marion Cremoni; Laurent Bailly; Kevin Zorzi; Caroline Ruetsch-Chelli; Vesna Brglez; Alexandra Picard-Gauci; Laura Troin; Vincent L M Esnault; Thierry Passeron Journal: J Immunother Cancer Date: 2021-06 Impact factor: 13.751